Clinical Significance Of Combination Of CRP And D-2 Polymers In Early Diagnosis Of Acute Pancreatitis Severity

Objective: To explore the clinical value of CRP and D-2 polymers in predicting the severity and risk of death in the early stage of acute pancreatitis.Method: A total of 138 patients diagnosed as acute pancreatitis admitted to the first hospital in Hefei City from May 2019 to May 2022 were selected.According to the classification standard of Atlanta,the included patients were divided into mild pancreatitis(MAP)and non-mild pancreatitis(moderate and severe acute pancreatitis),and divided into cure group and death group according to the clinical treatment.General clinical data(age,sex,pulse,temperature,blood pressure,blood glucose,etc.)were collected and registered within 24 hours upon admission.Venous blood samples(BUN,D-dimer,CRP,blood calcium)were collected from the bedside of patients.Ranson score of each patient was also measured.Using the obtained data as independent variables,U test and Chi-square test were used to analyze whether the difference between the two groups was statistically significant.The obtained data(CRP and D-dimer)were respectively correlated with Ranson score by pearman analysis.The independent risk factors for predicting the severity of severe pancreatitis were obtained by binary logistic regression analysis,and the early clinical diagnosis prediction model of severe pancreatitis was established.The ROC curve was drawn based on the clinical data of patients,so as to obtain the sensitivity,specificity,area under the curve and the optimal cut-off value.Results: Among the 138 patients,102 had mild symptoms and 36 had non-mild symptoms.Thirty healthy patients were selected.(1)Compared with the healthy control group,CRP and D-dimer were significantly increased in the acute pancreatitis group,with no significant difference in age.(2)We found that CRP,D-dimer,BUN,and length of stay were significantly increased in patients with non-mild pancreatitis;Blood calcium decreased significantly;There was no significant difference in age and BUN.We also found that patients with high blood pressure and diabetes were more likely to develop SAP.(3)Pearson correlation analysis of D-dimer,CRP and Ranson score showed a significant positive correlation,r1=0.55,r2=0.88;(4)logistic regression analysis showed that CRP,D-dimer and blood calcium were independent risk factors for predicting the prognosis of SAP.The difference was statistically significant(P<0.05).In the ROC curve analysis to predict non-mild pancreatitis,the AUC of CRP was 0.808,the sensitivity was 0.80,the specificity was 0.74,and the optimal cut-off value was 94.38.The AUC of D-dimer was 0.803,the sensitivity was 0.60,the specificity was 0.89,and the optimal truncation value was 2.28.The combined index was 0.882 AUC,0.667 sensitivity and 0.935 specificity.According to the results of binary logistic regression analysis,CRP,D-dimer and BUN had no statistical difference in predicting the risk of death(P>0.05),and were not independent risk factors for predicting the risk of death.Conclusions: The combination of D-dimer and CRP has high sensitivity and specificity in predicting the severity of acute pancreatitis,which can be used as an important predictor for early diagnosis of severe pancreatitis...